Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA.
Pediatr Res. 2012 Feb;71(2):205-9. doi: 10.1038/pr.2011.30. Epub 2011 Dec 21.
We sought to determine whether 18- to 22-mo neurodevelopmental outcomes predicted functional outcomes at 7-8 y for survivors of the CoolCap study of therapeutic hypothermia for neonates with hypoxic-ischemic encephalopathy.
WeeFIM ratings were completed at 7-8 y of age on 62 (32 cooled; 30 standard care) of 135 surviving children who had had neurodevelopmental assessment at 18 mo. There was 1 refusal, 58 lost to follow-up, and 14 children whose centers declined to participate. Disability status at 18 mo was strongly associated with WeeFIM ratings (P < 0.001); there was no significant effect of treatment (P = 0.83).
Functional outcome at 7-8 y of survivors of neonatal encephalopathy is associated with 18-mo neurodevelopmental assessment, supporting the long-term predictive value of a favorable outcome at 18 mo assessed by published trials of therapeutic hypothermia.
All surviving children who participated in the CoolCap study and were assessed at 18 mo were eligible for reassessment using the WeeFIM instrument that qualitatively measures self-care, mobility, and cognitive function. Center investigators obtained consent from the families for a certified researcher to administer the WeeFIM instrument by phone.
我们旨在确定 18 至 22 个月的神经发育结果是否能预测接受低温治疗的缺氧缺血性脑病新生儿 CoolCap 研究中幸存者 7 至 8 岁时的功能结局。
在 135 名幸存儿童中有 62 名(32 名接受冷却治疗;30 名接受标准治疗)在 7 至 8 岁时完成了 WeeFIM 评分,他们在 18 个月时已经进行了神经发育评估。有 1 名拒绝,58 名失访,14 名儿童的中心拒绝参与。18 个月时的残疾状况与 WeeFIM 评分密切相关(P<0.001);治疗无显著影响(P=0.83)。
新生儿脑病幸存者在 7 至 8 岁时的功能结局与 18 个月时的神经发育评估相关,支持通过已发表的低温治疗试验对 18 个月时有利结局进行评估的长期预测价值。
所有参加 CoolCap 研究并在 18 个月时进行评估的幸存儿童都有资格使用 WeeFIM 工具进行重新评估,该工具定性测量自我护理、移动性和认知功能。中心研究人员获得了家庭的同意,由认证研究人员通过电话来管理 WeeFIM 工具。